A new soft transglenoidal suture anchor for arthroscopic labrum fixation.

Inherent in most transglenoidal suture stabilization techniques of unstable shoulders is the unreliable fixation of posterior knots on the fascia. The transglenoidal suture anchor (TSA) technique overcomes this disadvantage. The TSA is a 1.5-cm loop of a No. 3 braided polyester thread with 5 knots. The loop is loaded with 1 or 2 sutures. Using a transglenoidal shuttle suture, it is pulled into a transglenoidal drill hole from the back in a retrograde fashion. The anchor is stopped at the posterior cortex of the glenoid by the knot. Using an arthroscopic suture passer technique (Bird Beak; Arthrex, Naples, FL) sutures are applied in the anterior-inferior part of the capsule, tied with a self-locking sliding knot, and secured with 2 or 3 additional throws. Two or 3 TSAs with 1 or 2 threads per anchor are used in most cases. The ultimate failure load of 10 samples of the anchor was tested with porcine scapulae. It was more than 156 N in every case. This technique enables the surgeon to use up to 4 anchors in the unstable shoulder with 1 or 2 sutures per anchor. The anchors are inexpensive. No problems are encountered in case of revision. There is no abrasion in the eyelet of the anchor as with metallic anchors and no synovitis as with some absorbable anchors.